StateLicensed

Emergency Medical Technician (EMT) License Requirements in Maryland

Verified · July 2026
Training hours
165 hrs
Upfront cost
$104
Exam
NREMT EMT Cognitive Examination, Maryland EMT Psychomotor Exam
Renewal cycle
Every 3 years
Issuing board
Maryland Institute for Emergency Medical Services Systems (MIEMSS), Office of EMS Clinician Services

How to get licensed

  1. 1

    Meet the prerequisites

    Be at least 16 years old, pass a criminal background check. MIEMSS's Initial Certification FAQ and EMT program page require applicants to be 16 or older (except as modified by COMAR 30.02.02.03 for certain minors), with those under 18 needing parental/guardian consent for clinical training. Applicants must also be currently affiliated with a Maryland BLS EMS operational program. MIEMSS's certification workflow includes an 'Office of Integrity' approval step, and a criminal background check is required before certification (and separately, typically, by the hiring EMS operational program). [2]

  2. 2

    Complete approved training

    Complete 165 hours of training at a state-approved program. MIEMSS's own EMT program summary states the EMS Board-approved EMT course runs 'approximately 165 hours.' COMAR 30.02.02.03 requires completion of an EMS Board-approved EMT course plus a MIEMSS-approved internship but does not itself state a fixed hour figure; 165 hours is MIEMSS's published programmatic figure, not a hard regulatory floor, so a given approved program could vary slightly. [1]

  3. 3

    NREMT EMT Cognitive Examination

    Pass the NREMT EMT Cognitive Examination (fee: $104). Computer-adaptive test administered at Pearson VUE test centers or via OnVUE remote proctoring. Maryland's initial-certification checklist requires passing the 'National Registry EMT-level cognitive exam' rather than a separate MIEMSS-written exam (this replaced an older MIEMSS-administered written exam referenced in some legacy program documents). Fee is NREMT's published national rate and is paid to NREMT/Pearson, not to MIEMSS. [2]

  4. 4

    Maryland EMT Psychomotor Exam

    Pass the Maryland EMT Psychomotor Exam. Unlike many states, Maryland administers its own state-specific psychomotor (skills) exam rather than deferring to NREMT's psychomotor exam. Candidates register for it through the MIEMSS eLicensure Portal after their internship packet is approved. No published exam fee was found on the MIEMSS site, so left null rather than guessed. [2]

  5. 5

    Submit your application

    Submit your application to Maryland Institute for Emergency Medical Services Systems (MIEMSS), Office of EMS Clinician Services. [2]

  6. 6

    Receive your license

    Once your application is approved, Maryland Institute for Emergency Medical Services Systems (MIEMSS), Office of EMS Clinician Services issues your Emergency Medical Technician (EMT) for Maryland.

Fees

Fee Amount
Application fee [2] None specified
License fee [2] None specified
Renewal fee [2] None specified
NREMT EMT Cognitive Examination [2] $104
Maryland EMT Psychomotor Exam [2] None specified

No MIEMSS application, certification, or renewal fee is published on the initial-certification, EMT program summary, or renewal pages; MIEMSS's application process runs through its free eLicensure Portal. The only fee identified is the $104 NREMT cognitive exam fee paid to Pearson VUE (recorded under exams, not here). Left null rather than guessed since no state fee schedule page was located.

Renewal & continuing education

Renew every 3 years. 24 continuing education hours required per cycle.

Maryland EMT certification is valid for 3 years. Two renewal pathways exist: (A) maintain current active NREMT registration plus complete the 3 most recent years of Annual Maryland Medical Protocols Updates, or (B) complete 24 hours of continuing education in MIEMSS-designated categories (airway/ventilation, cardiovascular, trauma/burns, medical, pediatrics, etc., with up to 9 hours substitutable via hands-on skills verification) plus the same protocol updates. An older MIEMSS program sheet describes a legacy 12-hour CE + 12-hour skills refresher combination; the current renewal-certification page's 24-hour CE pathway figure is treated as authoritative since it is the actively maintained page.

Reciprocity

Endorsement/reciprocity from another state is available.

Maryland is not a current member of the EMS Personnel Licensure Interstate Compact (REPLICA) per the compact commission's own commissioners list (as of access date). Maryland instead runs its own Reciprocity process (COMAR 30.02.02.04): an applicant holding an out-of-state EMS certification/license or NREMT certification submits a reciprocity application with copies of current certificates/licenses, must be affiliated with a Maryland EMS operational program at the level sought, and for EMT must complete a minimum 12-hour Maryland EMT Skills Refresher Course.

12 state-approved training providers in Maryland — browse programs and compare schools on tradecolleges.org.

Cost calculator

  • $104
Total$104

Frequently asked questions

How many hours of training does Maryland require to become an EMT?

MIEMSS's EMT program summary states the EMS Board-approved EMT course runs approximately 165 hours, followed by a MIEMSS-approved internship before certification exams.

What exams does a Maryland EMT candidate need to pass?

Candidates must pass the NREMT EMT cognitive exam (delivered via Pearson VUE) and the Maryland EMT Psychomotor Exam, which MIEMSS administers itself rather than using NREMT's psychomotor exam.

Are there state fees to become a Maryland EMT?

MIEMSS does not publish an application, certification, or renewal fee; applications are submitted through its free eLicensure Portal. The main cost identified is the $104 NREMT cognitive exam fee paid to Pearson VUE.

How often do Maryland EMTs need to renew?

Every 3 years. Renewal requires either maintaining current NREMT registration plus completing 3 years of Maryland Medical Protocols Updates, or completing 24 hours of continuing education in MIEMSS-designated categories plus those same protocol updates.

Can an EMT certified in another state get certified in Maryland?

Yes, through MIEMSS's Reciprocity process: submit a reciprocity application with current out-of-state certificates, obtain EMS operational program affiliation, and complete a minimum 12-hour Maryland EMT Skills Refresher Course. Maryland is not a member of the EMS Compact (REPLICA), so this state-run reciprocity route is the only path.

Sources

  1. [1] miemss.org/home/Portals/0/Docs/EducationCert/EMT_Basic.pdf — accessed 2026-07-12
  2. [2] miemss.org/home/ems-providers/initial-certification — accessed 2026-07-12
  3. [3] miemss.org/home/renewal-certification — accessed 2026-07-12
  4. [4] miemss.org/home/ems-providers/reciprocity — accessed 2026-07-12